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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Value of glucose transport protein 1 expression in detecting lymph node metastasis in patients with colorectal cancer
Hongsik Kim, Song-Yi Choi, Tae-Young Heo, Kyeong-Rok Kim, Jisun Lee, Min Young Yoo, Taek-Gu Lee, Joung-Ho Han
Hongsik Kim, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju 28644, South Korea
Song-Yi Choi, Department of Pathology, Chungnam National University College of Medicine, Daejeon 35015, South Korea
Tae-Young Heo, Kyeong-Rok Kim, Information and Statistics, Chungbuk National University, Cheongju 28644, South Korea
Jisun Lee, Department of Radiology, College of Medicine, Chungbuk National University, Chungbuk National University Hospital, Cheongju-si 28644, South Korea
Min Young Yoo, Department of Nuclear Medicine, School of Medicine, Inha University, Incheon 22332, South Korea
Taek-Gu Lee, Department of Surgery, Chungbuk National University, College of Medicine, Cheongju-si 28644, South Korea
Joung-Ho Han, Department of Internal Medicen, Chungbuk National University, College of medicine, Cheongju-si 28644, South Korea
Co-first authors: Hongsik Kim and Song-Yi Choi.
Author contributions: contributed to Kim H, Choi SY, Heo TY, Kim KR, Lee J, Yoo MY, Lee TG, and Han JH conceptualization, data curation, writing—review & editing; Heo TY and Kim KR contributed to formal analysis, software; Han JH contributed to funding acquisition, project administration, supervision; Kim H, Choi SY, Heo TY, Kim KR, and Han JH contributed to investigation, methodology, validation; Kim H and Choi SY contributed to visualization; Kim H, Choi SY, and Han JH contributed to writing - original draft.
Institutional review board statement: The Institutional Review Board (IRB No. 2013-03-003) of Chungbuk National University Hospital approved this study.
Informed consent statement: The requirement for written informed consent was waived due to retrospective design of the study.
Conflict-of-interest statement: The authors have no conflict of interest to declare regarding the publication of this work.
Data sharing statement: IRB of CBNUH did not permit sharing the raw data of patients without consent.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Joung-Ho Han, MD, PhD, Professor, Department of Internal Medicen, Chungbuk National University, College of medicine, No. 1 Chungdae-ro, Seowon-gu, Cheongju-si 28644, South Korea. joungho@chungbuk.ac.kr
Received: November 9, 2023
Peer-review started: November 9, 2023
First decision: December 21, 2023
Revised: January 4, 2024
Accepted: January 22, 2024
Article in press: January 22, 2024
Published online: February 16, 2024
BACKGROUND
There are limited data on the use of glucose transport protein 1 (GLUT-1) expression as a biomarker for predicting lymph node metastasis in patients with colorectal cancer. GLUT-1 and GLUT-3, hexokinase (HK)-II, and hypoxia-induced factor (HIF)-1 expressions may be useful biomarkers for detecting primary tumors and lymph node metastasis when combined with fluorodeoxyglucose (FDG) uptake on positron emission tomography/computed tomography (PET/CT).
AIM
To evaluate GLUT-1, GLUT-3, HK-II, and HIF-1 expressions as biomarkers for detecting primary tumors and lymph node metastasis with 18F-FDG-PET/CT.
METHODS
This retrospective study included 169 patients with colorectal cancer who underwent colectomy and preoperative 18F-FDG-PET/CT at Chungbuk National University Hospital between January 2009 and May 2012. Two tissue cores from the central and peripheral areas of the tumors were obtained and were examined by a dedicated pathologist, and the expressions of GLUT-1, GLUT-3, HK-II, and HIF-1 were determined using immunohistochemical staining. We analyzed the correlations among their expressions, various clinicopathological factors, and the maximum standardized uptake value (SUVmax) of PET/CT.
RESULTS
GLUT-1 was found at the center or periphery of the tumors in 109 (64.5%) of the 169 patients. GLUT-1 positivity was significantly correlated with the SUVmax of the primary tumor and lymph nodes, regardless of the biopsy site (tumor center, P < 0.001 and P = 0.012; tumor periphery, P = 0.030 and P = 0.010, respectively). GLUT-1 positivity and negativity were associated with higher and lower sensitivities of PET/CT, respectively, for the detection of lymph node metastasis, regardless of the biopsy site. GLUT3, HK-II, and HIF-1 expressions were not significantly correlated with the SUVmax of the primary tumor and lymph nodes.
CONCLUSION
GLUT-1 expression was significantly correlated with the SUVmax of 18F-FDG-PET/CT for primary tumors and lymph nodes. Clinicians should consider GLUT-1 expression in preoperative endoscopic biopsy in interpreting PET/CT findings.
Core Tip: Glucose transport protein 1 (GLUT-1) expression is a significant predictor of lymph node metastasis in patients with colorectal cancer. Positron emission tomography/computed tomography showed a higher sensitivity for detecting lymph node metastasis for GLUT-1-positive tumors, suggesting that GLUT-1 expression can be used to improve the accuracy of preoperative staging and guide treatment planning in patients with colorectal cancer.
